GENEVA, June 5 (UNHCR) - A year after troubled Somalia was ravaged by the worst drought in decades, no end seems in sight to more than two decades of suffering and Somalis continue to flee their country to escape conflict, human rights abuses and adverse weather conditions.

In the first four months of this year, some 20,000 Somalis sought refuge in neighbouring Kenya, Ethiopia, Djibouti and Yemen. Although the levels are lower, they are significant. On average 40,000 Somalis fled their homeland each month between June and September of 2011.

In May, the Dollo Ado camps in eastern Ethiopia, which were already hosting more than 150,000 refugees, saw a significant increase in new arrivals, from less than 980 in the first half of May to more than 2,000 in the second half.

The newcomers say they are fleeing increased physical insecurity and dwindling food resources. Specifically, they cite fear of being caught in military operations, forced recruitment, poor rains and crop destruction by caterpillars as reasons for leaving Somalia. "We are working with the Ethiopian authorities to identify a site for a sixth camp in this already crowded and environmentally fragile area," Andrej Mahecic, a UNHCR spokesman, said in Geneva.

Meanwhile, at Dadaab in north-east Kenya, more than 460,000 refugees continue to live in a precarious security environment. The threat of improvised explosive devices, shootings, kidnapping and banditry remains high. Deliveries of assistance and activities in the camps are continuing regardless.

Mahecic explained that the priority and toughest challenge for UNHCR and its partners throughout the past year has been to reduce the unprecedented mortality and malnutrition rates among Somali arrivals.

"Despite life-saving medical care and therapeutic feeding programmes in the Dadaab and Dollo Ado refugee camps, many of the newly arriving children have been beyond help - dying within hours or days of arrival. At the peak of the influx last summer, the estimated death toll was as high as 17 deaths per 10,000 people every day," he noted.

At the onset of last year's crisis, UNHCR and its partners set up critical nutrition programmes in reception and transit centres and in the camps. "Combined with mass vaccinations and other public health measures, these massive efforts saved lives over the past 12 months," Mahecic said. "Mortality and malnutrition rates began to drop from record highs in September last year, but it took another six months before they fell below the levels usually seen in an emergency - less than one per 10,000 per day," he added.

Today, Ethiopia's Dollo Ado camps are reporting an average crude mortality rate of 0.8 per 1,000 per month and an under-five mortality rate of 2.2 per 1,000 per month. In Kenya's Dadaab refugee complex the crude mortality rate is 0.2 per 1,000 per month, and 0.6 per 1,000 per month for children under five years of age.

"Another vital achievement has been the reduction in the high malnutrition rates, unseen in decades," Mahecic said. Malnutrition was especially alarming among refugee children - in June and July last year, more than half of Somali children arriving in Ethiopia were acutely malnourished. That rate was somewhat lower among those arriving in Kenya, but equally disturbing - between 30 and 40 per cent.

Mahecic said the results of the most recent mass screenings show a sharp reduction of malnutrition among under fives in Dadaab (seven per cent). In Dollo Ado, the malnutrition levels among children also stabilized with all camps showing a positive trend. In the older Melkadida and Bokolomayo camps, acute malnutrition rates have fallen to 15 per cent. UNHCR is currently preparing a follow-up survey in the newer Kobe and Hilaweyn camps and expects to see significantly reduced levels of general acute malnutrition.

Massive water, sanitation and hygiene programmes went hand-in-hand with these efforts and were integral to the vast improvements in the health conditions of the Somali refugee population.

Meanwhile, neighbouring countries have been bearing the brunt of the Somali displacement and they continue to need international support. Some 300,000 people fled Somalia last year alone. Today, more than 980,000 Somalis live as refugees in Kenya, Ethiopia, Yemen and Djibouti.